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Schizophrenia

Schizophrenia is characterized by perturbations of language, perception, thinking, social activity, affect, and volition, but there is no single symptom that is peculiar to this disorder.

1.                Epidemiology: lifetime prevalence is approximately 1 to 1.5 percent.

2.              Causes  (1) genetic vulnerability, (2) early developmental insults, and (3) winter birth

3.              Symptoms  (1) Delusions of reference (2) Delusions of persecution (3)Thought broadcasting (4) Delusion of mind reading (5) Thought withdrawal (6) Thought insertion (7) Delusions of Guilt or Grandiosity (8) Delusions of Control (9) Somatic Delusion (10) Hallucinations - visual, auditory, tactile, olfactory, gustatory (11) Negative symptoms

4.                     Treatment

a.     70% of people having a first psychotic break will respond to conventional antipsychotics

b.    If medications are completely discontinued, however, the relapse rate is about 60 percent within 6 months.  Many people will have further episodes even with compliance with their medications. Even those who respond to their medications will very often have residual symptoms and deficits in functioning.

c.     Side effects: the medicines can have serious side effects, including:  lethargy, weight gain, postural hypotension, constipation, dry mouth. Extrapyramidal symptoms such as dystonia (contraction of muscles), akathisia (restlessness), pseudo-Parkinsonism.  Risk of agranulocytosis with  clozapine requiring weekly blood-monitoring. Tardive Dyskinesia, characterized by repetitive, involuntary, and potentially irreversible movements of the tongue and lips and, in approximately half of cases, involuntary movements of the limbs